Where is the Uproar over Doctors Salaries?

And it doesn't take a genius to become a primary care physician... I just don't think you realize why such high standards are in place for post-medical school training.

 

Wow you are incredibly ignorant.

Let me guess, you think that 50% of the job of a physician is giving you a shot too?


Also, what makes you think that healthcare is better elsewhere? Since its so cheap there too, would you be willing to take yourself to a 3rd world country for a heart of kidney transplant?

 

Thats not really fair. Doing your residency in internal medicine (choosing not to do a fellowship later) makes you a primary care physician, but that training is incredibly rigorous and you won't be able to do it if you're not incredibly smart. Family Medicine residencies are pretty easy to get into and usually require the lowest Step 1 score, so I can see your point there.

Rocktman also seems to be caught up with Medical Schools themselves and doesn't realize that residency spots are being curbed to where there will only be enough room for U.S grads. Its competitive as it is, going into ENT, Optho, Derm. , Plastics, is one of the most competitive things you can do. It will ALWAYS stay that way simply due to the fact that everybody wants to go into them over other areas.

 

Doctors at least do something very useful compared to millionaire health care CEO's, insurance company middle men and armies of clerks who bill and or try to prevent folks from getting care.

Doctors also make much less than the folks on Wall Street-- probably 50% of whom are not even doing anything particularly useful.

I suspect that if you were to reduce physician's salaries by 50% the reduction on health care costs would be just a few percent.

 

Study after study shows patient outcomes to be as good or superior in many countries. I don't know the details of the studies, but patient outcomes would indicate comparing patients with a certain condition and the resulting care.

Have you ever received health care abroad?

 

You realize there are a lot of places in the world besides the US that are not 3rd world countries, right?

 

of course there are outliers and rare exceptions

 

France, Germany, Canada, Japan, and the UK are not Third World nations. My family and I along with some friends have received health care from physicians there, and our experience were excellent.

You can keep the post-medical school standards and certifications. These countries show that there's little need to go to medical school for so many years, for school to cost so much, for residency compensation to be so little, for working hours to be so long and inconvenient to doctors' personal lives, and for malpractice suits/testing being too frequent.

Doctors in America live in a partially self-made hell that costs them and Americans too much money. Although doctors in the developed countries above make less, they are far happier. Keep in mind these physicians are still upper-middle class in their respective societies. My neighbor earns between $500-650k/year, but I know he'd gladly take $150k in exchange for more free time, less student loan debt, and less malpractice threat.

That all being said, physician compensation is one component in why our health care system costs more vs other developed countries, and is less effective for the average person. That is another thread, however.

 

There are plenty of metrics such as infant mortality out there that the UN uses to track medical well-being in various countries. The US is regularly outperformed by other developed nations and often by developing countries. This is not only in terms of end results, but also efficiency. The second part is the real issue; other countries' medical systems perform as well or much better than the US with less financial input. A lot of it has to do with the AMA restricting the number of medical schools and medical students. The AMA is one of the most powerful lobbies in the US. As a professional organization, it's doing a fantastic job for its members, but that means consumers have to pay the premium. When this situation is coupled with an opaque insurance system that encourages consumer irresponsibility, you get the situation the US is in today.

That said, I wouldn't go to a foreign hospital in your hypo because it is true that the US is amongst the best in the world for complex procedures such as heart transplants and things with high R&D costs like pharmaceuticals. A lot of that could probably be credited, at least indirectly, to the AMA. The real issue is whether having an advantage like this is worth it because it only benefits a comparatively small group of people at great cost to the country as a whole. Another thing to consider is which other countries would bear the economic burden of being on the forefront of medicine, which has spillover benefits to the rest of the world.

 

give me some data on what percent of our health care costs are doctor's salaries and then we can talk. We know administrative overhead with private medicine is 25 to 30% so that is the biggest waste.

 

The link below is from 2007. I asked a friend earlier today who consults for hospitals, and she mentioned it was about 10% in 2013.

http://query.nytimes.com/gst/fullpage.html?res=9B00EEDE163AF936A3575BC0A9619C8B63

 

like any profession there are bad doctors and good doctors.. For the most part the surgeons and specialist earn their salaries.. there are also a lot of hacks that make high six figure salaries and are no more helpful than "Google"..

anyways I dont know where the problem is but it's just insane that some minor surgeries can cost upwards of $100k or a simple visit to the emergency can cause a few thousand dollars.. Dont know where the problem is and dont know how to fix it.. or whos right or wrong in the issue. I just know its pretty damn messed up.. but I wouldnt necessarily blame the doctors but the messed up system.

 

I've been seen by a Physicians Assistant at my GP and my Rheumatologist for routine care. I'm very comfortable with both. Both do happen to be smokin' but that's incidental.


Also I read this week that it takes $58 in clerical costs to process the average 12 minute doctor encounter.

 

And look at the other studies refuting these "outcomes" as the patient populations are not entirely comparable. Part of the problem is that a large majority of this countries sick/uninsured are also people who do not take care of themselves to begin with. Also, the litigious/malpractice nature of this country leads to far more unnecessary ER admissions (which is part of the "outcome" studies) than in other countries that don't sue every ER/doctor that lays a hand on them.

If you think a scenario as complex as healthcare is easily comparable amongst countries, its simply not the case.

Its alway shift-work, its always under a MD's supervision, and its with very little personal responsibility or liability if they make mistakes. If you promote PA's to be on their own, and make them start paying for malpractice insurance, and force them to handle their own patients (along with dealing with their own complications, taking after-hour calls, and have them work similar hours as an MD), its no longer the same "job" to them.

I already said I think more medical school spots is a great idea... but it won't cure the shortage as this country doesn't have enough residency spots to train every potential specialty to cure the shortage. Resident salaries (which are basically minimal wage if you account for hours worked) are funded by medicare taxes... more spots would likely need to be funded by the government, which raises taxes even more.

And again, there are existing medical students, who met the "hard" qualifications to beat out those other students to get into med school, who already don't make it all the way through residency, or choose to simply go into teaching or research (which doesn't help the "shortage"). Odds are, the less qualified applicant also faces the same if not worse concerns of matriculating.

The main issue is the increased funding that would be needed to train the additional med school graduates.

Go to any American specialty board website and you will see their goals. Again, they're not there to create artificial shortages, or else they'd be failing a set % of every class who takes their exam (instead of the theoretical 100% pass-rate that exists). Their sole job is to ensure that the board-certified physician is qualified to take care of patients to the highest held standards... and they create rigorous qualifications/exams to ensure that happens.

 

I wasn't intending to slight IM or FP, or any primary care specialty.

I was refuting this general belief that all doctors are "geniuses" and need to have the highest IQ's to get into med school. In the end, there are plenty of smart students who don't have the necessary stamina, drive, desire or work ethic to make it all the way through residency... a lot of them end up going into research or teaching (which contributes to the shortage of doctors actually taking care of patients).

While you don't need to be a genius to become a physician, you do have to have a serious drive/devotion/compassion/determination to spend 7-10 years of your life earning a bare-minimum salary, accumulating debt, working awful hours, and sacrificing most of your personal life in order to finally accomplish your goal.

 

IMO, the medical profession due to its very nature should be highly paid. At least the best ones. I mean, of all the things people care about, one's own health would rank near or at the top. So it would stand to reason that we'd all pay more premium for health than other things in life.

For comparsion sake from my experience in China. China theoretically has standard health care and doctors/nurses make "normal" salaries. But in reality they still make a lot more than other professions because socialized healthcare means they can earn more through bribes. So who gets to see the best doctor in the hospital? Who gets the best bedside treatment? The answer is whoever brides the right people the right amount. The market for good health is just way too high for doctors not to be raking in.

 

problem is the lack of primary care physicians because specializing is where the $$s at.

make pharmacists and PAs and RNs have a little bit more freedom to give them a little role of what a Primary care physician can do. alleviate some of the shortage of PCPs = lower demand = lowering of salaries -> -> -> maybe saturation of specialization market -> -> lowering of salary(?). Just pure thought and guess

They deserve every penny but there definitely is a problem

 

The outrage????? I have been in a relationship with my wife since she was in med school. You have no clue what you are talking about, nor do you have any clue what people go through in order to practice medicine.

14 years. 4 years of premed undergrad....arguably one of the harder majors in college. Then 4 years of medical school where you study your ass off all of the time. And not only do they have to study, they actually have to RETAiN what they learn and truly understand everything going on in the human body. A bit different than cramming for tests, memorizing things then never having to remember them or put them to practical use in your profession.

Next up comes 3-6 years of residency, where they make meager salaries and work 60-70 hours per week..being on call and having to work all hours of the night at times. The learning curve in residency is very steep and very stressful and requires lots of after work studying to learn. Then throw in the fact that they have to pass three levels of board exams while doing said residency. Exams where they have to study in their "free time" (aka very moment you are not working) for months before each exam, some of which still have 50% failure rate.

Once the residency is finished, many choose to spend 2 more years doing a fellowship, where they basically get their "masters" so to speak in a sub specialty in a field they plan to practice in and get to spend that time as a glorified resident working the same hours for the same crappy pay.

Once that is finally finished, usually in your early to mid 30's if you go to med school straight out of college, you emerge with $130k+ of debt and virtually zero savings and you can finally start to make some money.

Now you get to spend your days trying to help people while being surrounded by sickness and death the entire time you work as you try to help people. And no pressure whatsoever...a mistake only means someone can die...and everyone is going to make a mistake or two on any job during your lifetime.

You get to work terrible hours for as long as you work, often going on call a week per month where you either have to sleep at the hospital or get called in at any time of night to work. Did I mention you have to live in fear of messing up and misdiagnosing something and costing someone their life?

And while what you do is noble (not talking cosmetic surgeons here) and helps people and saves their lives, people complain because you make a six figure salary. Doctor's salaries are not why health care costs are out of control. Most doctors who are not surgeons make less than $300k per year, with many family practitioners making in the mid 100's. Your family doc's salary isn't why it costs so much for a checkup.

So no, I don't think people should be outraged and after seeing what a doctor goes through firsthand makes me laugh when you compare it to someone going to get their MBA or JD...both of which can lead to much higher salaries than what the average MD will make.

 

repped.

/ thread.